Shira (शिरस् or शिरः)

Shira (शिरस्/शिरः) in Samskrt denotes head. In Ayurveda Shira is known as one of the 3 extremely significant marmas (seats of prana or life energy). A lot of discussion about anatomy and physiology of shiras along with various diseases, pathological processes related to it can be found in Ayurveda literature. While describing all these aspects, the viewpoint of Ayurveda of looking at it is quite different from that of modern/western medicine. The same has been described here.

What is Shira according to Ayurveda

Shiras is also called as uttamanga in Ayurveda. Uttara means top or above and anga means a body part. Thus the part of body located in the topmost position is called as uttamanga. Also, uttama means best or of topmost quality/significance etc. Thus shiras is also known as that body part which is of topmost significance. The reason to call it of topmost significance is as follows,

प्राणाः प्राणभृतां यत्र श्रिताः सर्वेन्द्रियाणि च| यदुत्तमाङ्गमाङ्गानां शिरस्तदभिधीयते||१२|| (Char. Samh. Su 17.12)

Meaning: Shiras (head) is foremost among all organs as it is the part of the body where the life energy and all the vital centers of sensory and motor organs (indriyas) of a living-being are located. (Thus) It is vital (uttama) amongst all the other organs of the body.

Therefore it is clear that Shiras is the seat of all the sensory and motor organs according to Ayurveda. Also being one of the marmas, the life energy is also concentrated at this place. It indicates that, any injury to this part of the body will certainly affect indriyas, pranas and thus the entire life. It is also clear from the above discussion that, ancient Ayurveda scholars very well knew the level of seriousness of neurological disorders, the center of all of which is situated in brain and nerves that are situated inside head.

Anatomy related Shiras

Ayurveda acharyas have counted Shiras in one of the 6 angas knows as Shadangas in Human.

तच्च षडङ्गं- शाखाश्चतस्रो, मध्यं पञ्चमं, षष्ठं शिर इति ||३|| (Sush. Samh. 5.3)

Entrance or Gateway It is also described that Nose is the entry point of shiras. It has been described like follows,

द्वारं हि शिरसो नासा तेन तद् व्याप्य हन्ति तान्||८८|| Cha. Si 9.88

Bahirmukha strotas

Nose is counted as one of the bahirmukha strotasa (channel of passage for various body elements having opening on outer surface of body) along with 5 other such openings situated in head. The other 5 openings are 2 eyes, 2 ears and 1 oral cavity.

Marma

Shiras is known as one of the vital points or marmas.

सप्तोत्तरं मर्मशतं यदुक्तं शरीरसङ्ख्यामधिकृत्य तेभ्यः| मर्माणि बस्तिं हृदयं शिरश्च प्रधानभूतानि वदन्ति तज्ज्ञाः||३|| प्राणाश्रयात्, तानि हि पीडयन्तो वातादयोऽसूनपि पीडयन्ति| (Char. Samh. chi 26.3-4)

Total 107 marmas have been listed by Ayurveda scholars. Among them 3 are extremely significant and vital. Shiras is one of these 3 vital marmas. Since this is the seat of life energy any disturbance in this point will lead to disturbance in life in total.

Bones, Joints, muscles and other structures related to shiras have been discussed in Ayurveda literature at relevant places. Apart from the shiras being a marma itself, simanta, the fine lines of joint between skull bones known as Simantas have also been counted in marmas and effect of injury to them is also described.

The internal structure of pathways of various sensory and motor organs along with seat of prana (life energy) is said to be present in a particular manner in Shiras. Ayurveda acharyas have explain this structure in a simplified way with the help of a similie. They say that, like the radiating spicules of the rays of sunlight that seem to be present far away somewhere from the sun but originate from only one center i.e. Sun, all these Indriyas and prana (life energy) are situated in Shiras but could be seen/manifested anywhere else over the body.

शिरसि इन्द्रियाणि इन्द्रियप्राणवहानि च स्रोतांसि सूर्यमिव गभस्तयः संश्रितानि, (Ch siddhi 9.4)

Effect of head injury

Shiras is one of the 3 most highly important marmas in the body. IT is known that if injury to anyone of these occurs, the person may loose life and can be left severly injured. This has been mentioned by Acharya Charka in the following sutra,

तेषां त्रयाणामन्यतमस्यापि भेदादाश्वेव शरीरभेदः स्यात्, आश्रयनाशादाश्रितस्यापि विनाशः; तदुपघातात्तु घोरतरव्याधिप्रादुर्भावः; तस्मादेतानि विशेषेण रक्ष्याणि बाह्याभिघाद्वातादिभ्यश्च||५|| ??Char. Samh. chi 26.3-4) or (Char. Samh. Siddh 9.5) Menaing: Injury to any of these three vital marma which includes shiras (basti and hriday being other two marma), leads to sudden pain all over body. Destruction of the ashraya(substance) leads to destruction of the ashrita(substrate). Severe disease manifestations occur due to injury, thus shiras must be protected especially from external injury and vata dosha.

Specifically due to head injury certain signs and symptoms can arise and those are as follows,

• Neck stiffness,
• facial paralysis,
• eye disorders,
• mental confusion,
• loss of bodily movements,
• cough,
• breathlessness,
• stiffness of jaw,
• excessive yawning and etc.

Doshas and shiras

kapha- शिरःस्थः स्नेहसन्तर्पणाधिकृतत्वादिन्द्रियाणामात्मवीर्येणानुग्रहं करोत् (Su su 21.14)

Preventive

Benefits of nasya in preventing shirorogas

वर्षे ^[१] वर्षेऽणुतैलं च कालेषु त्रिषु ना चरेत्||५६|| प्रावृट्शरद्वसन्तेषु गतमेघे नभस्तले| नस्यकर्म यथाकालं यो यथोक्तं निषेवते||५७||

न च केशाः प्रमुच्यन्ते ^[२] वर्धन्ते च विशेषतः| मन्यास्तम्भः शिरःशूलमर्दितं हनुसङ्ग्रहः||५९|| पीनसार्धावभेदौ च शिरःकम्पश्च शाम्यति|

सिराः शिरःकपालानां सन्धयः स्नायुकण्डराः||६०|| नावनप्रीणिताश्चास्य लभन्तेऽभ्यधिकं बलम्| Cha . su 5.59-60

Benefits of shiro abhyanga

नित्यं स्नेहार्द्रशिरसः शिरःशूलं न जायते| न खालित्यं न पालित्यं न केशाः प्रपतन्ति च||८१||

बलं शिरःकपालानां विशेषेणाभिवर्धते| दृढमूलाश्च दीर्घाश्च कृष्णाः केशा भवन्ति च||८२||

इन्द्रियाणि प्रसीदन्ति सुत्वग्भवति चाननम् ^[१] | निद्रालाभः सुखं च स्यान्मूर्ध्नि तैलनिषेवणात्||८३|| Cha Su. 5 81-83

Avoid daytime sleep

शिरःशूलं स्तैमित्यं गुरुगात्रता|.....भवेन्नृणां दिवास्वप्नस्याहितस्य निषेवणात्| (Char. Samh. Suu 21.46-49)

Causes of shiro rogas

Vega vidharna /sthana vaigunya

Purisha- पक्वाशयशिरःशूलं वातवर्चोऽप्रवर्तनम् ^[३] | पिण्डिकोद्वेष्टनाध्मानं पुरीषे स्याद्विधारिते||८|| Char. Samh. Su 7/8

Kshawathu- मन्यास्तम्भः शिरःशूलमर्दितार्धावभेदकौ| इन्द्रियाणां च दौर्बल्यं क्षवथोः स्याद्विधारणात्||१६||Char. Samh. Su 7/16

Causes of shiroroga general

सन्धारणाद्दिवास्वप्नाद्रात्रौ जागरणान्मदात्|

उच्चैर्भाष्यादवश्यायात् प्राग्वातादतिमैथुनात्||८||

गन्धादसात्म्यादाघ्राताद्रजोधूमहिमातपात्|

गुर्वम्लहरितादानादति शीताम्बुसेवनात्||९||

शिरोऽभिघाताद्दुष्टामाद्रोदनाद्बाष्पनिग्रहात् ^[१] |

मेघागमान्मनस्तापाद्देशकालविपर्ययात्||१०||

वातादयः प्रकुप्यन्ति शिरस्यस्रं च दुष्यति|

ततः शिरसि जायन्ते रोगा विविधलक्षणाः||११|| (Char. Samh. Su. 17.8-11)

others

तत्रोच्चैर्भाष्यातिभाष्याभ्यां शिरस्तापशङ्खकर्णनिस्तोदश्रोत्रोपरोधमुखतालुकण्ठशोषतैमिर्यपिपासाज्वरतमक- Cha. Si 12.14

रथक्षोभात् सन्धिपर्वशैथिल्यहनुनासाकर्णशिरःशूलतोदकुक्षिक्षोभाटोपान्त्रकूजनाध्मानहृदयेन्द्रियोपरोध- Cha. Si 12.14

व्यवायादाशुबलनाशोरुसादशिरोबस्तिगुदमेढ्रवङ्क्षणोरुजा Cha. Si 12.14

Tikta rasa atiyoga

Su su 42.15

Lifestyle related causes	Environmental factors	Vega suppression related	Miscellaneous
Day sleep	Exposure to excess cold or wind	Suppression of natural urges like (yawning, micturition etc)	Excessive loud speech (Cha. Si 12.14)
Sleeplessness	Cloudy weather	suppression of tears. (Char. Samh. Su. 17.8-11	Excessively speaking (Cha. Si 12.14)
Excessive indulgence in sexual activity	Excess sun exposure and wind exposure		Excessive crying (Char. Samh. Su. 17.8-11)
Over indulgence in heavy food items, sour tasting food	Constant exposure to dust, smoke.		Excessive stress.
Intoxication (alcohol or substance abuse)	Irregular climatic conditions.		Inhalation of strong toxic or unpleasant smell.
Usage of cold water for drinking.			Ama formation in the body.
Excessive intake of bitter food items.			Head injury.

Treatment aspects

Swedana-

प्रतिश्याये च कासे च हिक्काश्वासेष्वलाघवे| कर्णमन्याशिरःशूले स्वरभेदे गलग्रहे||२०|| अर्दितैकाङ्गसर्वाङ्गपक्षाघाते (Char. Samh. Su. 14.20-21)

Swedana is a therapy which means fomentation or sudation or simply steam therapy. There are various methods or types listed in Ayurvedic Samhitas regarding swedana therapy, which differs from disease to disease. Precisely the procedure which relieves stiffness, heaviness, obstruction and cold from body or a specific targeted area is called as swedana and in various Shiroroga(along with many other disorders), Swedana is used as one of the treatment procedure. (Char. Samh. Su. 14.20-21)(char.sut.22.11)

Jeerna ghruta

योनिकर्णशिरःशूलं घृतं जीर्णमपोहति||२३३|| (Char. SAmh. su 27.233) (Su su 45.107)

Jeerna ghruta means old preserved ghee, this is used orally as one of the treatment methods in shira shula (headache of certain type). Ghee In general has properties which enhances memory, intelligence, balances vata and kapha doshas and also improves digestion and metabolism.the properties of ghee vary based on the source of milk. (cow, buffalo, goat, sheep etc) (Char. SAmh. su 27.233) (Su su 45.107) (char.sutr.27.231)

Tailam

अथ तैलानि |

तैलं त्वाग्नेयमुष्णं तीक्ष्णं मधुरं मधुरविपाकं बृंहणं प्रीणनं व्यवायि सूक्ष्मं विशदं गुरु सरं विकासि वृष्यं त्वक्प्रसादनं मेधामार्दवमांसस्थैर्यवर्णबलकरं चक्षुष्यं बद्धमूत्रं लेखनं तिक्तकषायानुरसं पाचनमनिलबलासक्षयकरं [१] क्रिमिघ्नमशितपित्तजननं [२] योनिशिरःकर्णशूलप्रशमनं गर्भाशयशोधनं च (Su Su 45.112)

Nasya

Aternative name- Shiro virechana -

नस्तःकर्म च कुर्वीत शिरोरोगेषु शास्त्रविद्|

द्वारं हि शिरसो नासा तेन तद् व्याप्य हन्ति तान्||८८|| Cha. Si 9.88

Nasya karma also known as shiro virechana(that therapy which expels doshas situated in shiras) is one of the panchakarma therapy methods which means instillation of medicine (in the form of oil, powder, herbal liquid etc) through nostrils. This is primely indicated for the diseases of head and its associated structures. (asht,hrud.sutr.20.1) (Cha. Si 9.88)

Dhumapana

Dhumapana refers to herbal smoking, primarily indicated in diseases concerning with head and neck and in vata and kapha dosha related diseases. (asht.hrid.sutr.22.1)

Indicated in headaches of various kind, heaviness of head, runny nose, sinuses, cough. (Cha.Chi 18/65)

शिरसः पीडने स्रावे नासाया हृदि ताम्यति|

कासप्रतिश्यायवतां धूमं वैद्यः प्रयोजयेत्||६५|| - Commentary- शिरस इत्यादिना धूमयोग्यावस्थोपदर्शनपूर्वकं धूममाहशिरसः पीडने इत्यादि| शूलगौरवादिना शिरसः पीडने| (Cha.Chi 18/65)

In which rogas does shira gets affected or headache seen as symptom

V gulma- मन्याशिरःशङ्खशूल (Cha. samh. nidanasthana 3 Sutra 7)

Shirogandha-putita- in Pitta prakrti due to visrata- विस्रत्वात् प्रभूतपूतिकक्षास्यशिरःशरीरगन्धाः; (Charaka samhita vimanasthana Adhyaay 8 Sutra 97)

Ajeerna

तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा|

शिरसो रुक् च मूर्च्छा च भ्रमः (Cha. Chi 15/45)

Shwasa, kasa, Pinasa

प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते|

ग्रीवां शिरश्च सङ्गृह्य श्लेष्माणं समुदीर्य च||५५||

करोति पीनसं तेन रुद्धो घुर्घुरुकं तथा|

अतीव तीव्रवेगं च श्वासं (Cha. Chi 17. 56)

अधःप्रतिहतो वायुरूर्ध्वस्रोतःसमाश्रितः|

उदानभावमापन्नः कण्ठे सक्तस्तथोरसि||६||

आविश्य शिरसः खानि सर्वाणि प्रतिपूरयन्|

आभञ्जन्नाक्षिपन् (Cha. Chi 18. 6-7)

Pausing the vitiated blood flow-

स्रवणं चाप्युपेक्षेत लङ्घनैर्वा समाचरेत्||१७६||

प्रवृत्तमादावर्शोभ्यो यो निगृह्णात्यबुद्धिमान्|

शोणितं दोषमनिलं तद्रोगाञ्जनयेद्बहून्||१७७||

रक्तपित्तं ज्वरं तृष्णामग्निसादमरोचकम्| ..........वातमूत्रपुरीषाणां विबन्धं शिरसो रुजम्||१७९||

स्तैमित्यं गुरुगात्रत्वं तथाऽन्यान् रक्तजान् गदान्| (Cha chi 14.179)

V Trushna

निद्रानाशः शिरसो भ्रमस्तथा .... Cha chi 22.12

P trushna

शिरसो दाहः (cha. chi 22.14)

MAdatyaya

मद्योत्क्लिष्टेन दोषेण रुद्धः ^[१] स्रोतःसु मारुतः|

करोति वेदनां तीव्रां शिरस्यस्थिषु सन्धिषु||११७|| Cha. Chi 24.117

Pratishyaya as chief shiroroga

क्रमागतशिरोरोगचिकित्सायां वक्तव्यायां शिरोरोगप्रधानत्वाद्भूरिशिरोरोगहेतुत्वाच्च प्रतिश्यायमेव तावदाह|

संस्त्यानदोषे शिरसि प्रवृद्धो वायुः प्रतिश्यायमुदीरयेत्तु| (Char. Samh. Chi 26.105)

Dushtapratishyaya

दुष्टप्रतिश्याय -

सर्वोऽतिवृद्धोऽहितभोजनात्तु दुष्टप्रतिश्याय उपेक्षितः स्यात्||१०७||

ततस्तु रोगाः क्षवथुश्च .......अरूंषि शीर्षश्रवणाक्षिरोगखालित्यहर्यर्जुनलोमभावाः| (Cha.Chi 26.107-109)

Durvirikte

गलोपलेपः शिरसो गुरुत्वं निष्ठीवनं चाप्यथ दुर्विरिक्ते| (Char. SAMh. SIddhi 1.52)

Migrain / Ardhavabhedaka

केवलः सकफो वाऽर्धं ^[२] गृहीत्वा शिरसस्ततः|

मन्याभ्रूशङ्खकर्णाक्षिललाटार्धेऽतिवेदनाम्||७५||

शस्त्रारणिनिभां कुर्यात्तीव्रां सोऽर्धावभेदकः| Cha. Si 9. 74-76

Ardita

वक्रीभवति वक्त्रार्धं ग्रीवा चाप्यपवर्तते |

शिरश्चलति वाक्सङ्गो नेत्रादीनां च वैकृतम् ||७०||

ग्रीवाचिबुकदन्तानां तस्मिन् पार्श्वे तु वेदना | Su ni 1. 70